Understanding Musicians’ Perspectives on Primary Healthcare Needs and Service Accessibility in Canada: A Mixed-Methods Study

Musicians face a distinct set of health challenges closely tied to the nature of their work. These include performance-related injuries, mental health concerns, and difficulty accessing suitable care within a healthcare system that rarely accounts for the realities of creative labour. Despite their cultural and economic contributions, musicians are often overlooked in health policy and service planning. This study aimed to explore how musicians in Canada experience primary care, what barriers they encounter, and what changes might make healthcare more responsive to their needs.

We used a mixed-methods approach, combining an anonymous national online survey with four virtual focus groups. The survey, completed by 657 musicians between May and June 2024, included questions on access to care, satisfaction with provider relationships, appropriateness of their provider's treatment plans, and barriers to services. Two hundred $10 gift cards were offered to early respondents. All focus group participants (n=11) received a $30 gift card. Qualitative data were analysed using inductive thematic analysis, and survey data were summarised descriptively.

Among survey respondents, 92.4% reported having a primary care provider. However, only 69.6% felt their health needs were being met, and just 37.7% said their provider’s care plan reflected the specific demands of being a musician. Fewer than half (42.5%) felt listened to when raising music-related concerns in clinical settings. Among those who were not offered an incentive, only 50.9% reported their care needs were met—compared to 76.8% of those who received a gift card.

Barriers to care were widespread. Over half (56.5%) of survey participants said their providers lacked an understanding of musicians’ physical and psychological demands. Financial constraints were cited by 51.9% as a reason for delaying or avoiding care. Nearly half (48.4%) had difficulty accessing appropriate services, and 47.8% said stigma—either from within the music world or from anticipated provider responses—had discouraged them from seeking help.

The focus groups provided depth and context to these figures. Participants described feeling that their identities and experiences as musicians were not recognised or valued in healthcare settings. Several said they had to explain or justify the nature of their work repeatedly and felt dismissed when describing symptoms. One participant recalled being told that their pain was “normal for their age,” with no recognition of how even minor physical issues could compromise their ability to perform.

Mental health emerged as a central concern. Participants described high levels of stress, anxiety, burnout, and in some cases trauma, including grief and experiences of assault. Some reported avoiding care because previous encounters had left them feeling invalidated. The impacts of the COVID-19 pandemic were still being felt—many participants had lost work, support systems, and a sense of identity tied to performance. Several described ongoing isolation and emotional strain.

Structural and financial issues were also prominent. Most participants were self-employed or freelanced across multiple contracts, with little to no access to extended health benefits. This meant routine care, mental health support, and rehabilitation services were often unaffordable. Some described situations where care was technically available but not practically accessible due to long wait times, provider shortages, or transport limitations.

Cultural factors within the music world further shaped access to care. Participants working in educational institutions or professional ensembles said there was often pressure to work through illness or injury. Freelancers worried that being open about health issues might affect their reputations or lead to lost opportunities. Many described a culture of silence around pain and burnout. In contrast, peer networks were widely seen as supportive spaces for information and validation.

Participants had clear ideas about what could improve care. A large majority (88.4%) of survey respondents said they would be more likely to seek healthcare if providers had some awareness or training in musicians’ health needs. Suggestions included building networks of clinician referrals tailored to musicians, integrating health and wellness education into music training, and offering flexible appointment models. Some also proposed publicly available resources that musicians could bring to appointments to help explain their work context more clearly.

This study identifies a substantial gap between access to primary care and its adequacy for musicians in Canada. While most are technically attached to care, many feel unseen, misunderstood, or unsupported. Their experiences point to a need for systemic reform: more than simply expanding services, healthcare for musicians must be restructured to account for the ways creative labour intersects with physical health, mental wellbeing, and at times social precarity. Musicians are an integral part of Canadian public life—and they deserve a healthcare system that recognises the realities of their work and supports their capacity to thrive in a way that is informed, accessible, and responsive.